European Heart Journal

European Heart Journal 1999 20(4):278-284; doi:10.1053/euhj.1998.1276
Copyright © 1999 by the European Society of Cardiology.

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Prolonged QT interval predicts cardiac and all-cause mortality in the elderly

The Rotterdam Study

M.C. de Bruyne^a,b, A.W. Hoes^a,c, J.A. Kors^b, A. Hofman^a, J.H. van Bemmel^b and D.E. Grobbee^a,c

^a Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam
^b Department of Medical Informatics, Erasmus University Medical School, Rotterdam
^c Julius Center for Patient-Oriented Research, Utrecht University Academic Hospital, Utrecht, The Netherlands

revised July 28, 1998; accepted July 29, 1998

Abstract

Aims To examine the association between heart-rate corrected QT prolongation and cardiac and all-cause mortality in the population-based Rotterdam Study among men and women aged 55 years or older and to compare the prog-nostic value of the QT interval, using different formulas to correct for heart rate.

Methods and Results After exclusion of participants with arrhythmias or bundle branch block on the ECG, the study population consisted of 2083 men and 3158 women. The QT interval was computed by the Modular ECG Analysis System (MEANS). Data were analysed using Cox’ proportional hazards model. Participants in the highest quartile of the heart-rate corrected QT interval had about a 70% age- and sex-adjusted increased risk for both all-cause mortality (hazard ratio (HR) 1·8; 95%CI:1·3–2·4) and cardiac mortality (HR 1·7; 95%CI:1·0–2·7) compared to those in the lowest quartile. In women, the increased risk associated with prolonged QT for cardiac death was more pronounced than in men. These risk estimates did not change after adjustment for potential confounders, including history of myocardial infarction, hypertension and diabetes mellitus.

Conclusion A prolonged heart-rate corrected QT interval is an independent predictor for cardiac and all-cause mortality in older men and women. The risk associated with prolonged QT is hardly affected by the heart-rate correction formula used.

Key Words: Electrocardiogram • coronary heart disease • mortality • aged • risk factor • prolonged QTc interval

Correspondence: Martine de Bruyne, MD, PhD, Deptartment of Epidemiology & Biostatistics, Erasmus University Medical School, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.

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